In remote Australian Indigenous communities high rates of infection during children’s vital growth and development stage impacts not only on their growth and general wellbeing, but also on their cognitive development and educational outcomes. It places them at greater risk of developing chronic diseases later in life. This thesis investigates the problem of poor hygiene as it currently occurs in many remote Indigenous communities in the Northern Territory from an ecological perspective. It is comprised of literature reviews which investigate a) the physical and social barriers that currently hinder people living in these communities from achieving safe levels of hygiene; b) hygiene interventions for which there is good evidence of effectiveness and which are likely to achieve a sustained reduction in the incidence of infections among children; and c) the extent that existing models of health promotion are suitable to promote hygiene in remote Indigenous communities. The extent that poor housing, crowding and a low standard of hygiene contribute to the poor health of children is investigated by means of community based studies. A further study investigated the level of knowledge about the transmission mechanisms of common childhood infections and the attitudes held by community members towards hygiene behaviours. Key findings suggest that to reduce effectively rates of common infections among children multifaceted interventions are required. This is to ensure that household water and sanitation technology are functional, hygiene behaviour change is achieved, and environments are created that enable good hygiene behaviour. The hygiene behaviours considered most essential for community members to adopt are isolating human and animal faeces from the environment and handwashing with soap at key times. To implement this intervention a framework for action such as the World Health Organization’s Healthy Cities Framework and an ecological model of health promotion is proposed. Collectively, these measures can inform the development of policies and programs which aim to improve hygiene and the health of children living in remote Indigenous communities.

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